AGED CARE SUPPORT WORKERS INSURANCE

For more information, please review our FAQ page.
Please complete the form below to obtain a quotation and arrange cover today.

Insured name

Is your turnover greater than $150,000?YesNo

State

DECLARATION FOR PURPOSES OF SEEKING SMALL BUSINESS EXEMPTION UNDER DUTIES ACT 1997 (NSW)
NSW Small Business Stamp Duty Exemption Declaration
At the time that the contract of insurance being applied for is effected or renewed (as applicable), I am/will be a small business as defined in section 259A of the Duties Act 1997 (NSW) (the Act) for the purposes of the small business exemption in section 259B of the Act. YesNo

Postal Address

Email Address

Phone number

From the following two options, please select the occupation description applicable to the work performed:

Have you obtained all necessary qualifications to carry out your work? (Select “no” if there are no qualifications required for your position)YesNo

DISCLOSURE QUESTIONS

Are you aware of any circumstance or incident which may give rise to a claim against you?YesNo

If “Yes”, please give details

Are you aware of any prosecution or investigation (actual or pending) of your business under any international, commonwealth, state or local statute, legislation, regulation or by law or have you ever been subject to any disciplinary action, been fined or penalised, or been the subject of an inquiry investigation or alleging professional misconduct?YesNo

If “Yes”, please give details

Have you ever had any insurer decline a proposal, imposed any special terms, cancelled or refused to renewal a professional indemnity insurance policy?YesNo

If “Yes”, please give details

Contact Us

For professional advice or further information about the Products & Services that we offer, please contact us.